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Adherence and the Authentic Truth

After a patient initiates treatment, the real selling-process begins. More than ever, patients are approaching Rx-trialing with a heavy dose of skepticism. It’s understandable. Oftentimes, long-term treatment is thrust upon patients without time to get comfortable. And sometimes, those patients have healthy fears over side effects. On the other side of the coin, many patients expect treatment to fix everything fast or they diminish the value of Rx treatment altogether (before giving it a real chance).

This net skepticism has fueled – no, skyrocketed – a behavior patients hold dear when trialing treatment. And that is finding the authentic truth – conducting their own in-depth exploratory research into Rx treatment expectations, outside of brand communications. Outside of the brand context is where patients perceive to find this authentic truth and the optimal basis for their own opinions and behaviors toward Rx treatment.

Here, I’ll explore this rising phenomenon a bit more and then present an opportunity for brand adherence communications. Essentially, I’ll show you how to guide patients toward external content, in order to help them find their own, preferred version of the truth. In the end, they want to put the “authentic” puzzle pieces together. If we can help them do that, we can help them feel more comfortable with treatment early on and more receptive to the rewarding possibilities of long-term treatment.

Origins of the truth
A year or so ago, I spent time reflecting on the success of online services such as Angie’s List, Yelp, and others, with large investments into customer review networks. I came to one conclusion: in the digital age, the truth comes from strangers.

My hope is that this speaks to you, as both logically flawed and intuitively accurate. Let me explain. Logically speaking, we put our trust in people/entities we know, or in some cases, those we think we know. In this case, the ol’ saying “never trust a stranger” holds true. But today, we live in a hyper-consumerized world where we have many “long-term relationships” with an array of organizations and companies we really “know” little about (e.g., mobile phone, streaming, cable, grocery delivery, etc.). We expect those companies to meet our expectations or, in other words, be trustworthy.

In many cases, the results have been less than stellar. However, there are exceptions. Brands like Zappos and Wayfair have elevated the benchmark of customer service to a religion – but again, these are exceptions. And, the fault cannot be placed entirely on either side – it’s a combination of consumers and companies. Consumers can exaggerate or even create the problems, yet companies (or brands) aren’t exactly model citizens, when the almighty dollar rules the day.

Regardless of who’s right and who’s wrong, the net result has been a heightened mistrust among consumers. You could even say it’s already hit the boiling point with persistent steam ahead. Who can we trust these days?

The person/entity we often trust is the person/entity with no vested interest in us: the stranger. They don’t want our money, our commitment, or a relationship. They do have opinions, though – invaluable ones about the subjects that matter most to us. And they like to voice these opinions. It’s these anonymous voices we seek in order to find the authentic truth and, as a result, make better decisions.

The patient “truth-seeking” journey

This is the kind of approach patients take when trialing Rx treatment. They get the doctor’s version of the story, they get the brand version (e.g., brochure, site), and then they go looking for the outsider context: the anonymous opinion, the unknown academic perspective, the clinical trial data, the virtuous community site, and even sponsored content, but on a trusted site.

Now, let’s bring these learnings back to the question at hand: how can Rx brands become an integral part of the content system patients tap into when finding their authentic truth?

First, I have to acknowledge that this is not a one-stop shopping experience for patients. They will leverage this behavior at multiple points during treatment. In my experience, the best way to manage this is to glean the most important barriers to short-term, intermediate, and long-term adherence. Typically, short-term issues surround potential side effects, whereas intermediate and long-term issues usually surround side effect experiences, efficacy, and cost.

On the subject of cost, we often think of cost-saving programs benefitting patients just starting treatment. What I’ve learned is that most patients wrestle with treatment value relative to cost, once they’ve come to the conclusion that they’ve experienced said treatment’s full potential. For the commercially insured, if their treatment co-pay is negligible (through a branded support program), they will likely accept average efficacy, for example, and stay on treatment longer.

So, how do we use branded content to encourage adherence, while embracing a patient’s journey to find the authentic truth? Below are five recommendations to help you, and your patients, succeed:

1.     Use a trustworthy environment to evolve your brand marketing into brand truth. In the case of a patient’s search for more information, the environment may be more important than the content itself. In pharma, where there’s a lot of scrutiny, the context in which consumers find your brand message can have a major impact on the credibility and trustworthiness of the content itself. This is because a trustworthy environment is perceived to only house trustworthy content. As an analogy, when are you expected to be on your best behavior? Answer: When you’re in someone else’s home. Then, when you go home you can be as sloppy and loud as you want to be. The point is that the environment your brand message lives in influences the perceived value of your message.

To accomplish this, leverage portable brand content on sites or with organizations that deal in truth. For example, health blog sites with strong followings are generally successful because the site is valued for one thing above all else: the truth. Brand content within this context will be viewed as trustworthy, and can also be longer. In order to amplify the “authenticity” of your brand content, think less about banner ads and more about portable content capsules. These are essentially miniaturized microsites that provide a comprehensive experience within an external site environment.

In addition, consider partnering with a news organization that will develop and conduct influencer conferences about a particular topic that’s relative to your brand. While I’m not here to promote specific news organizations, I can say with experience that these capabilities exist among them. Not only can you sponsor these conferences, but once the event is done, you have access to the content (post-production). This not only shows leadership, but it proves to your patients that the brand is entrenched into the broader health context and can be taken seriously.

2.     Market clinical studies without feeling like your marketing clinical studies. The more patient research I’m involved with, the more I hear, “I’m the kind of person who looks for any clinical studies done on the drug.” Well, it seems like “that kind of person” has become almost every person. Patients are savvier than ever with information and see clinical studies as a way to break through to the “real” facts. Increasingly, patients are looking for clinical research to find the authentic truth.

Therefore, I recommend leaving a consumer-friendly trail of clinical research breadcrumbs. Instead of just feeding the MOA through branded communications, think about consumerizing clinical data (think infographics, even), and seeding the content to academic sites and health foundation organizations. If there is heavy demand for clinical studies among your patients, consider a microsite or a content capsule mentioned in recommendation #1. Also, consider inviting a health information organization to write about the scientific category of drugs to which your brand is connected. From there, you can promote the article in branded CRM communications or even look to find ways to ensure the content is conducive for search and easily found by patients.

3.     Gain their trust by setting them free. If your brand can demonstrate to the patient that it encourages them to peruse and discover product information elsewhere, the brand can be perceived as acting with greater transparency, and with information accurately corroborated in both branded and external environments.

One way to tackle this is through a traditional CRM. Leverage CRM to promote outside sources of information about your brand – not in a heavy promotional sense, but in a way that provides the patient with an alternative channel to find essential brand information. Think about linking out to a channel like WebMD or even Wikipedia. If the opportunity exists, partner with the outside channel on shaping the story with additional accurate information.

4.     Let patients – even help them – find the good and bad about your brand. Consumers are skeptics. Instead of proactively looking for the good, they are attuned to looking for what’s wrong with a product. Deep down, most consumers believe there must be something they can find that will sound an alarm. It’s a defense mechanism that allows them to feel a greater sense of control. The more they know, the more they are in a position to validate a decision to continue treatment or discontinue.

With your communication partners, I recommend developing content ideas that present both the pros and cons of treating with your brand. Patients are skeptical of brand information cast only in a positive light. By balancing the content out in a “Pros and Cons” format, the information will be seen as more credible, and if guided correctly, the pros will stand out as the guiding principal for long-term usage.

In many cases, you can turn this into an exercise in targeting – using product cons to identify who the product is not right for, while using pros of the product to help your target agree with the positive benefits of staying on treatment. The more control of information they have, the more control they will feel with your brand. Drop-off often happens when patients don’t have the full story. Using this format helps patients have both sides of the story – including the truth they seek.

5.     Lastly, recognize how search can unearth issues patients were never searching for. Most think of search as a method of matching interest to information (with precision). But given all the negative content on the Rx category/brands, I see search these day as a tool that can open Pandora’s Box. Even general search queries can pull information about your brand that patients never intended to find. Cryptic stories, Rx lawsuits, you name it – we’ve all seen it.

To overcome this issue, maintain constant vigilance over negative stories surrounding your brand so that your team can put a search/content plan in place to proactively combat this issue. In a perfect world, search should be focused on matching interest to information, but search can be a battlefield that brand teams must actively manage. When brand teams are proactive, there’s a lesser chance of negative sentiment taking over. With more and more people unwilling to complete Rx trial, let alone stick with treatment long-term, this is paramount.

Patients hold all the power these days. Let’s help them realize that dream… and get rewarded for it.

EDITOR’S NOTE: This is the full-length version of John’s article. An abbreviated version ran in the April issue of DTC in Focus. For more information on the DTC in Focus newsletter, please visit www.dtcperspectives.com.

John Nelson
VP, Strategic Planning at Evoke Health New York
John Nelson has spent over 13 years in advertising, working with some of the most iconic health brands of our time. In his role as VP, Strategic Planning at Evoke Health New York, John is responsible for inspiring strategy that creates big ideas and big connections between brands and people – connections that drive behavior change and deliver tangible results for clients.

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